Background: Relapse is frequent among substance abusers all across the world, and Bangladesh is no exception. Drug-related issues are gradually becoming a hot topic in Bangladesh, from a social, economic, and medical standpoint. The present study aimed to find out sociodemographic factors associated with relapse amongst substance abuser. Material & Methods: This descriptive type of observational study conducted in the Combined Military Hospital and other Government/Private Hospital/Institute especially Central Drug Addict Treatment Center, Dhaka with a total sample size of 36 participants. Detailed information was obtained in each case according to protocol through complete history from patients or their accompanying attendants using a data collection sheet which was read out to them in Bangla. All the information was recorded in the pre fixed protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS-23. Results: The study found that yaba was the most commonly abused drug among 36 participants, with 27.78% reporting abuse. 27.78% of participants had a psychiatric illness, with the majority being male (97.22%) and Muslim (88.89%). The largest group of participants were aged 31-40 (47.22%) and most were unemployed (83.33%) and married (94.44%). Peer pressure and family problems were the most commonly reported causes of relapse (91.67% and 83.33%, respectively). Other factors such as unemployment, depression, and failure in life also contributed to relapse. Conclusion: Yaba was the most prevalent substance of abuse and the majority of participants were male, had a psychiatric illness, and were unemployed. Peer pressure and family problems were the main causes of relapse.
In 1951, Richard Alan John Asher first reported Munchausen syndrome as a factitious disorder. The essential feature of this disorder is that patients feign physical symptoms to get admission in a hospital. These patients may feign symptoms of disorder of any organ system. Even experienced clinicians are deceived by these symptoms and histories presented by these patients. Usually they know which of the symptoms and diagnoses usually require hospital admission or medication. Because of rarity of this disease and lack of knowledge and awareness even among the physicians, often misdiagnosis occur which results in unnecessary use of medical tests and evaluations. For these reasons this is one of the toughest and challenging diagnoses in any medical set up. We present this rare case of a patient who presented to the department of emergency, ENT and Eye repeatedly with Bleeding per nose, ears, eyes and mouth for 8 months. The patient was successfully treated, initially with psychotropic then psychotherapy with no recurrence. This interesting and rare case is presented to create awareness amongst all specially to medical population about Munchausen syndrome so that they can be diagnosed easily and treated with efficiency as well as misdiagnosis and unnecessary use of medical resources can be avoided. JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 237-239
Background: Relapse amongst substance abusers is common throughout the world, and Bangladesh is no exception to this. In Bangladesh, drug related problems are gradually becoming a burning issue in context of social, economical and medical perspective. The present study aimed to find out factors indicating relapse amongst substance abuser. Methods: This descriptive type of observational study was conducted in the combined military hospital and other government/private hospital/institute, especially the central drug addict treatment center, Dhaka. Informed consent was obtained prior to data collection. Collected data was classified, edited, coded, and entered into the computer for statistical analysis by using SPSS-23. The chi-Square test was used to analyze the categorical variables, and a p<0.05 was considered as statistically significant. Results: The study involved 100 patients who had a history of substance abuse. The most common substance abused was Yaba (27%), followed by cannabis (21%). The average duration of abuse for Yaba was 5.8 years, while the longest mean duration was for Alcohol (14.2 years). In the 2nd admission, the largest percentage of patients was aged 21-30 years and were male. The majority of patients were Muslim and were either unemployed or had a lower socioeconomic status. Patients age, occupation, socioeconomic status, peer pressure, and family problems all had a significant association (p<0.05) with relapse at different admissions. Peer pressure and family problems were also identified as factors affecting relapse, with 67.57% and 56.76% of patients experiencing them during their 2nd admission, respectively. Conclusions: The study found Yaba to be the most commonly used drug, followed by cannabis, phensedyl, heroin, etc. Alcohol was found to have the longest duration of abuse. Most patients were aged 21-30 and unemployed in multiple admissions. Peer pressure and unemployment were major factors in substance abuse, and psychiatric illness was a common factor in relapse. The results align with global findings and highlight the need for a comprehensive approach to addressing substance abuse, considering all relevant factors.
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